For data that is exchanged today though non FHIR methods we have seen groups send data points that help drive provider action and prioritize outreach. The key data elements that we are missing are the last time the gap was addressed and the next time it would become due. Technically MeasureReport.evaluatedResouces could reference encounters and with that encounter and the knowledge of the measure itself we could calculate the next due date but this could be difficult. This would also restrict this knowledge to groups that will be able to give us robust encounter references (this will depend on capabilities of their Outcome Calculation system and Clinical Data repositories)

Suggested Solution: Extend MeasureReport to hold Last Relevant Service Date and Clinical Due Date.

• Last Relevant Service Date: The last date the service that satisfies the quality measure was performed.  
• Clinical Due Date: The next date a clinical service that satisfies a quality measure is due. This due date is based on the frequency with which the service must be completed and the last date it was completed.